title: [Utility of single photon emission computed tomography-computed tomography in selective sentinel lymph node biopsy in patients with melanoma].
abstract: OBJECTIVE
  To assess the contribution of SPECT-CT lymphoscintigraphy in selective sentinel lymph node biopsy (SLNB) in patients with newly diagnosed malignant melanoma.
  
  
  METHODS
  A prospective study was made between July 2009 and October 2010. It included 63 patients diagnosed with melanoma (32 men and 31 women) with mean age of 55 years (range: 25-88) and inclusion criteria for SLNB. The melanomas were located as follows: 28 in trunk, 5 in head and neck, 16 in upper limbs and 17 in lower limbs. Three patients had two melanomas. Preoperative lymphoscintigraphy was performed after pericicatricial/perilesional injection of 74MBq of (99m)Tc-labeled nanocolloid human serum albumin, obtaining early planar images, late whole body study and sectorial images and SPECT-CT in the area of interest. Planar scintigraphy findings were compared with SPECT-CT.
  
  
  RESULTS
  The sentinel node (SN) was localized by planar imaging in 62/63 (98%) of patients. SPECT-CT study located the SN in all the patients with a detection rate of 100%. The number of SNs detected with SPECT-CT was higher than with the planar study in 27 patients. The SPECT-CT provided additional information (change in location and/or in its accuracy in the localization of location uncertain SN) in 14/63 (22.2%) patients, involving changes in the surgical approach and lymph node staging.
  
  
  CONCLUSIONS
  SPECT-CT detects a higher number of SN than planar lymphoscintigraphy in patients with melanoma. Its contribution is more relevant in the melanomas located on the trunk, head and neck. SPECT-CT modified the SN location by 22% compared to planar scan findings, facilitating a correct surgical approach.
authors.affiliation: Servicio de Medicina Nuclear, Unidad de Diagnóstico por la Imagen, Hospital Universitario Virgen del Rocío, Sevilla, España. Electronic address: rubenmaca@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Martínez Castillo
authors.affiliation: Servicio de Medicina Nuclear, Unidad de Diagnóstico por la Imagen, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: R
authors.initials: R
authors.lastname: Fernández López
authors.affiliation: Servicio de Medicina Nuclear, Unidad de Diagnóstico por la Imagen, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: I
authors.initials: I
authors.lastname: Acevedo Bañez
authors.affiliation: Servicio de Medicina Nuclear, Unidad de Diagnóstico por la Imagen, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: R M
authors.initials: RM
authors.lastname: Alvarez Pérez
authors.affiliation: Servicio de Medicina Nuclear, Unidad de Diagnóstico por la Imagen, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: D
authors.initials: D
authors.lastname: García Solis
authors.affiliation: Servicio de Medicina Nuclear, Unidad de Diagnóstico por la Imagen, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: R
authors.initials: R
authors.lastname: Vázquez Albertino
authors.affiliation: U.G. Cirugía Plástica, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: P
authors.initials: P
authors.lastname: Fernández Ortega
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D061305:Lymphoscintigraphy; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D008875:Middle Aged; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D015899:Tomography, Emission-Computed, Single-Photon
keywords: Ganglio centinela; Linfogammagrafía; Lymphoscintigraphy; Melanoma; Sentinel lymph node; Single photon emission computed tomography-computed tomography; Tomografía de emisión de fotón único-tomografía computarizada